Patient Treated for Breast Cancer: Thoughts on Dental Implant Treatment Plan?
I have a 53-year old female patient who was successfully treated for breast cancer with surgery, chemotherapy and radiation therapy. Â Her last PET scan in November 2011 showed no sign of recurrence. Â She has recovered and is stable and is in good health now with now restrictions for dental treatment. Â I have treatment planned her for implants. Â Is there any set of tests I should request prior to treatment? Â Are there any risks other than those for a normal healthy patient? Are there any complications I should be aware of?
21 Comments on Patient Treated for Breast Cancer: Thoughts on Dental Implant Treatment Plan?
New comments are currently closed for this post.
Blah
6/9/2012
No
John Kong, DDS
6/10/2012
Some patients treated for breast cancer are also placed on IV bisphonates as part of therapy. You should ask and not place dental implants on these patients to avoid osteonecrosis.
Najeeb Hussain
6/12/2012
Please consider this patient to be at high risk of failure following any implant placement. Though it is not the breast cancer itself, but the treatment choice to cure breast cancer that could lead to potential complications following dental implant placement.
As you have mentioned, this patient had radiotherapy to cure her breast cancer. An irradiated jaw bone is less likely to osseointegrate compared to a normal jaw bone. Obviously this depends on the radiation dosage, time elapsed since radiotherapy etc.
The best course of action at this point would be to contact the oncologist and radiologists, who are more likely to indicate the chances of success with you implant placement. There is no specific test I am aware of, which can indicate she will be a successful implant patient.
Yes, you have to approach with caution in this patient, unlike normal patients.
Michael W. Johnson DDS, M
6/12/2012
radiation for breast cancer does not involve the jaws. There are no contraindications for implant placement except IV bisphosphonates and that was not listed as part of the treatment.
Dr. Germán J. alenzuela
6/12/2012
For personal reasons the sugested is make one time betwen the last radiation and the time to start whit implant tratment minium 2 years for the best result off the implants placement
Baker vinci
6/12/2012
This is not true. Or should I say, your statement has no scientific merit. Bv
Husband and Dentist of wi
6/12/2012
Wife recently completed breast cancer surgery. Radiation was for 6 weeks, 5days/week only to the surgerized breast area. Wife had CT Conebeam scan to plan exact site for radiation. Gene specific lab test for agressiveness of cancer cells determined to tumor to be at very low risk and therefore no systemic chemo therapy required.
Breast Surgeon, Oncologis and Radiologist all new I was a dentist, they did not give any indications that if dental implants in future required not to be placed.
Only if IV Bisphosphonate required would she have been at high risk for osteonecrosis of the jaw. Hope this helps
sergio
6/14/2012
I will be careful about what some oncologists say about this topic. I had a patient who gets IV bisphosphonate once a month for breast cancer tx and she needed ext/endo on #13. I recommended against ext. The patient spoke to her oncologist and he suggested take 1 month off and then have the tooth taken out. Obviously, I called him and had a chat. He did'nt even know that half life of the drug is more than a decade. In the end he suggested to the patient to have endo done and the patient, of course, listened to him.
sergio
6/14/2012
It's sad that patients listen to oncologists more than us about dental tx.
Baker vinci
6/12/2012
I don't think they use bisphosphonate meds for breast ca.! Bv
John Kong, DDS
6/13/2012
Bv, a significant number of patients with breast cancer develop skeletal metastases, so some oncologist use it as a component of their treatment strategy. Google it.
Baker vinci
6/13/2012
John, you are correct. If you read the question, however, this patient is in remission. This means no evidence of disease, no nodal dz. and no mets.. If she has a skeletal secondary, implants are not something for which she needs to be concerned. Bv
Baker vinci
6/15/2012
John, I refuse to med search, before commenting on this site, in that this is a means of discussing opinions, based on experience and acumen. At your request, I did search primary Chemo meds for breast ca's. Bisphosphonate meds do not fall into that category! Just thought we should know. The primary reason for consulting the oncologist in my opinion, would be to asses the immune status of the patient. Radiation dosing, in this scenario, is of no concern. I hope this sheds some light on the query. Bv
John Kong, DDS
6/21/2012
Bv, I know iv bisphosphonates are not Chemo meds, I never said that. However, when you ask a patient how they were treated for cancer, they are going to reply with either radiation, resective, or chemo. They are not going to check off "iv bisphosphonates" in their med hx form b/c most forms don't even have that. There are however a significant number of breast cancer patients who are placed on iv bisphosphonates. So, it's a good idea to get a medical consultation to be sure; that is all.
Baker vinci
6/22/2012
John, bisphosphonates are in fact chemo medications. They are the primary drugs for bony tumors, specifically multiple myeloma and as you said, some skeletal mets. I was merely trying to clear up the issue of wether they were a primary chemo med for breast ca's. As Richard said, all surgical doctors must have a discussion with the oncologist, before proceeding. I am not trying to fight with you! Bv
Vinci oral and facial surgery, baton rouge. La.
Jan
2/11/2018
You are wrong! I am a six yr survivor.. they not only use bisphosphonates they PUSH them..
Jan
2/11/2018
I had mini dental implants placed by a dentist while I was taking a hormone blocker Femara. He told me my oncologist cleared it..he NEVER contacted her and I am having problems..my cancer was a Stage III.. 6 chemos 36 radiation treatment and double mastectomy..I am in the middle of a mess. Any suggestions would be appreciated.
Richard Hughes, DDS, FAAI
6/12/2012
Confer with the oncologist and radiation oncologist to discuss the medication sad radiation dosage. Then make your decision to treat with or without implants.
Baker vinci
6/13/2012
Richard is correct, in my opinion . This is " standard of care "! Bv
Baker vinci
6/20/2012
Just Recieved clearance from an oncologist, to place implants in a 50 year old, that is just beginning chemotherapy. He mandated that I get a CBC and a chem 7, before proceeding. Bv
Vinci Oral and Facial Surgery inc.
Baton Rouge, La.
Lori Foley
2/12/2018
I am scared to Death to have another implant.The first one was necessary 8mth process.I newly diagnosed with two forms of Breast Ca,Papilary and Triple negative. I just don't want my Chemo to be delayed. I will be having Double Mastectomy and a Hysterectomy then Radiation to follow. Will the Chemo and Radiation cause the implant to fail?
